Amlodipine for Heart Failure

Rarely prescribed for this condition

(LifeWire) - If your heart can't pump enough blood to circulate it to all your organs, you are experiencing heart failure. Lowering your blood pressure is key to treating your problem. For many people, taking a calcium channel blocker (like amlodipine Norvasc) is one of the best ways to turn hypertension into just-fine normal tension.

Amlodipine lowers blood pressure by slowing the movement of calcium into the heart muscle and vessel walls. Those tissues relax, resulting in an increased blood flow. This improved circulation can also reduce angina (pain) that often comes with heart failure.

But amlodipine -- and other calcium channel blockers -- are not often prescribed for heart failure patients because they may worsen the condition.  According to Daniel Yip, M.D., a cardiologist at the Mayo Clinic in Jacksonville, Florida, amlodipine is a drug of last resort in heart failure, used only after other blood-pressure-lowering medications have failed.

Side Effects

Amlodipine has a number of possible side effects you should be aware of:

• Fatigue
• Flushing (a feeling of warmth and reddening of the skin)
• Swelling of the ankles, feet or abdomen
• Lightheadedness
• Headache
• Upset stomach
• Heartburn

Tell your doctor if you experience any of these side effects and if they are severe or persistent.

Some other side effects -- such as fainting, rapid or irregular heartbeat, and worsened angina -- are rare but more serious, and should be reported immediately.

Drug Interactions

You should be aware that amlodipine can interact -- in a bad way -- with a number of other drugs including:

• Some other heart medications, such as niacin
• Blood pressure medications, including beta blockers, angiotensin-converting enzyme (ACE) inhibitors and diuretics (water pills)
• Digtalis, a drug used to strengthen the heart muscle
• Anti-arrhythmia drugs, the drugs used for irregular heartbeats
• Some eye medications, such as those containing the antibiotic erythromycin and Ocu-Mycin (gentamicin).
• Cortisone, or any other medication containing cortisone
• Calcium and vitamin D, especially in large doses
• Oral contraceptives, as taken by some women

Smoking while taking amlodipine can also cause the side effect of speeding up your heartbeat.

It has been reported that drinking grapefruit juice can increase the effect that some calcium channel blockers have on the body. But amlodipine is only modestly, if at all, affected.

Before beginning amlodipine, make sure your doctor knows if you have diabetes or prediabetes, food or dye allergies, pregnancy plans, experiences with depression, and, of course, if you have any heart-health news to share.

For patients with mild heart failure who are not in the hospital, amlodipine and other calcium-channel blockers may be prescribed only after other medications such as diuretics have been tried.

According to a study published in 2006 in Circulation: Journal of the American Heart Association, not only are diuretics less expensive, but they work better to bring down blood pressure in patients whose heart failure is not further complicated by other medical issues.

Finally, anyone taking amlodipine should have their blood pressure checked regularly.

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